Organization of equanimous practices in primary health attention within the metropolitan area with respect to social inclusion and exclusion processes

Abstract

This article presents an organization of primary health attention guided by the concept of equality, within the social justice context, for population groups in social exclusion situations in the central region of the city of Sao Paulo. The social transformations observed in the region are complex, marked by the heterogeneity of the population groups within the social inclusion/exclusion processes. Inclusion through social policies is an essential item of integration policies, guided by the need to decrease social inequalities. It is necessary to organize work processes that give visibility to these social groups and incorporate their demands into health care, linking them to other social practices. For this aim, primary health care services are ideal. Barra Funda Educational Health Center organized work processes to provide visibility and differentiated attention to these segments. During this process, some groups became visible and were included in health care: the street population; the sex professionals in the region of Luz; the Bolivian immigrants and those living in shantytowns. As part of its technology, the service incorporated the health care of differentiated groups of the population in general, individualizing them, creating specific "entrance doorways", and promoting equanimity in access. Conceptual and methodological challenges were employed in the consolidation of these practices, which required analyses of the social inclusion/exclusion processes, and of the styles of health care, such as integrality and autonomy of the subjects.